2026 Volume 9 Issue 2 Pages 41-47
This study evaluated the effects of pharmacist-led multidisciplinary conferences on deprescribing and reducing anticholinergic risk in older inpatients, assessed in part using the Japanese Anticholinergic Risk Scale (JARS). In 2021, we retrospectively analyzed 130 older inpatients admitted to Tokyo Medical University Hospital who were prescribed six or more medications at admission. Patients were divided into a conference group (C group, n ＝ 75) and a non-conference group (nC group, n ＝ 55). The primary outcome was the proportion of patients achieving deprescribing, which was defined as discontinuation at discharge. Secondary outcomes included drug classes and reasons for deprescribing and changes in JARS. Deprescribing occurred in 65% in the nC group and 87% in the C group (p < 0.05). Frequently deprescribed drug classes included antihypertensives, laxatives, and antithrombotics. Reasons for deprescribing were dysphagia, symptom resolution, consideration of potential adverse drug events, and others. JARS reduction was observed in 20% in the nC group and 44% in the C group (p < 0.05). To adjust for potential confounders, multivariable logistic regression analysis was performed with outcomes of deprescribing and JARS reduction, conference implementation as the main independent variable, and age, sex, BMI, eGFR, length of stay, and history of stroke as covariates. Length of stay was significantly associated with deprescribing, while JARS reduction was significantly associated with both the C group and length of stay. Pharmacist-led conferences were independently associated with a reduction in anticholinergic burden. Length of stay was also associated with deprescribing.
